Tailoring the Approach to the Individual Patient

Clinicians should remember that one size does not fit all. Some patients depend on your clinical recommendations while others will only want you to lay out their clinical alternatives. Giving recommendations is part of being a good doctor. Recommendations may seem odd in some contexts; if a patient is choosing, for example, between two treatments that yield identical survival rates but different complications, it would seem that the choice entirely depends on the patient's views of the various complications. And yet, may patients expect their doctors to tell them what to do and will be anxious if too much of the decision is laid at their feet.72 In such cases, physicians might do best to talk to patients about their various complications, to find out how patients feel about the complications, and then to make recommendations that seem to fit best with patients' values.

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